Accelerated radiotherapy in locally advanced head and neck cancer – early results

«Radiation and Risk», 2018, vol. 27, no. 2, pp.107-116

DOI: 10.21870/0131-3878-2018-27-2-107-116

Authors

Gordon K.B. – Researcher, C. Sc., Med. A. Tsyb MRRC, Obninsk, Russia. Contacts: 4 Korolyov str., Obninsk, Kaluga region, Russia, 249036. Tel.: (484) 399-33-91; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Gulidov I.A. – Head of Dep., D. Sc., Med., Prof. A. Tsyb MRRC, Obninsk, Russia.
Semenov A.V. – Jun. Res. A. Tsyb MRRC, Obninsk, Russia.
Radzhapova M.U. – Lead. Res., C. Sc., Med. A. Tsyb MRRC, Obninsk, Russia.
Sevrukov F.E. – Head of Dep., C. Sc., Med. A. Tsyb MRRC, Obninsk, Russia.

Abstract

The aim of the research was to evaluate the immediate efficacy and early toxicity of radiation therapy for locally advanced head and neck squamous cell carcinoma of the III-IVB stages. We used accelerated radiotherapy as independent form or in combination with chemotherapy. The material is presented by the results of treatment of 69 patients diagnosed with squamous cell carcinoma of the head and neck of the III-IVB stages. Mucositis grade 3-4 occurred in 7 (43.8%) patients in radiotherapy alone group, 9 (32.2%) patients in the induction chemotherapy group, 8 (32.0%) patients in the group of simultaneous chemoradiation treatment. Continuous treatment was conducted in 46 (66.6%) patients. Treatment with forced interruption was conducted in 23 (33.4%) patients. All patients (100%) who received a course of radiotherapy in an independent version transferred it without interruption. In the group with induction chemotherapy, there were 42.8%, and simultaneous – 20.8%. An objective tumor response to radiotherapy was registered in 63 (91.3%) patients. Significantly more often objective response was obtained in groups with induction and simultaneous chemotherapy. Differences were found in favor of adding to the treatment regimen locally advanced forms of head and neck cancer of chemotherapy in any of the variations (in comparison with radiotherapy alone) at the level of the statistical trend (p<0.05). The median follow-up was 5.5 months, the mean follow-up was 7.3 months. The 3-month overall survival of patients was 93.8±2.9%, 6-month – 84.0±4.9%, 9-month – 75,4±6.4%, 12-month – 71.8±7.0%. The level of local control for 3 months was 92.1±3.3%, 6 months – 83.3±5.1%, 9 months – 68.4±7.9%, 12 months – 66.1±8.3%. The obtained data testify to the good tolerability of radiation therapy in the regime of accelerated fractionation in an independent variant and in combination with induction chemotherapy. The combination of accelerated radiotherapy with simultaneous chemotherapy requires careful selection of patients.

Key words
Head and neck cancer, radiation therapy, induction chemotherapy, simultaneous chemotherapy, radiation reactions, overall survival, disease-free survival, treatment results, accelerated fractionation, altered fractionation.

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